Adapter assembly for surgical devices

ABSTRACT

An adapter assembly for connecting an end effector to a handle assembly includes first, second, and third drive assemblies configured for converting rotational motion from the handle assembly to linear motion for performing first, second, and third functions.

BACKGROUND

1. Technical Field

The present disclosure relates generally to powered surgical devices.More specifically, the present disclosure relates to adapter andextension assemblies for selectively connecting end effectors toactuation units of powered surgical devices.

2. Background of Related Art

Powered surgical devices for use in surgical procedures are known. Topermit reuse of the handle assemblies of powered surgical devices and sothat the handle assembly may be used with a variety of end effectors,adapter assemblies have been developed for selective attachment to thehandle assemblies and to a variety of end effectors. Following use, theadapter may be disposed of along with the end effector. In someinstances, the adapter assemblies may be sterilized for reuse.

SUMMARY

An assembly for operably connecting an end effector to a handle assemblyis provided. The adapter assembly includes a coupling assembly andfirst, second, and third drive assemblies. The first drive assemblyextends from the coupling assembly, defines a first longitudinal axis,and includes a first drive screw. The second drive assembly extends fromthe coupling assembly and is received about the first drive assembly.The second drive assembly defines a second longitudinal axis andincludes a second drive screw in direct engagement with the first drivescrew. The third drive assembly extends from the coupling assembly andis received about the first and second drive assemblies. The third driveassembly defines a third longitudinal axis and includes a third drivescrew in direct engagement with the second drive screw.

In embodiments, the coupling assembly includes first, second, and thirdconnector sleeves. The first connector sleeve may operably connect thefirst drive assembly to a first rotation transmitting member of a handleassembly, the second connector sleeve may operably connect the seconddrive assembly to a second rotation transmitting member of the handleassembly, and the third connector sleeve may operably connect the thirddrive assembly to a third rotation transmitting member of the handleassembly.

Each of the first, second, and third drive assemblies may include aproximal drive shaft, a distal drive shaft, and a drive screw. The firstdrive assembly may include a first drive screw having a threaded portionand a trocar member operably received about the threaded portion.Rotation of the first drive screw may cause longitudinal movement of thetrocar member. The first, second, and third longitudinal axes may beco-axial.

The first drive assembly may further include a thrust plate. The firstdrive screw may engage the thrust plate during operation of the firstdrive assembly. Each of the first, second, and third drive assembliesmay include a bearing assembly for rotatably supporting the respectivefirst, second and third drive screws.

The adapter assembly may further include a connection assemblyconfigured for operable connection to a handle assembly. Each of thefirst, second, and third drive assemblies may include a housing platefor supporting the respective first, second, and third drive screws. Thefirst, second, and third longitudinal axes may be offset from alongitudinal axis of a handle assembly.

The adapter assembly may further include an outer sleeve. Each of thefirst, second, and third drive assemblies may extend through the outersleeve. A distal end of the outer sleeve may be configured for operableconnection to an end effector.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present disclosure are described herein withreference to the accompanying drawings, wherein:

FIG. 1 is a perspective end view of an adapter assembly, in accordancewith an embodiment of the present disclosure, secured to an exemplaryhandle assembly and with an exemplary tool assembly secured thereto;

FIG. 2 is a perspective end view of the adapter assembly of FIG. 1;

FIG. 3 is a perspective side view of the adapter assembly of FIG. 1 witha handle member and sleeve removed, and secured to the handle assemblyof FIG. 1 (shown in phantom);

FIG. 4 is a cross-sectional side view taken along line 4-4 of FIG. 3;

FIG. 5 is an enlarged view of the indicated area of detail of FIG. 4;

FIG. 6 is a perspective end view of a coupling assembly and a drivemechanism of the adapter assembly of FIG. 1;

FIG. 7 is an enlarged perspective end view of the coupling assembly andthe drive mechanism of FIG. 6;

FIG. 8 is another enlarged perspective end view of the coupling assemblyand the drive mechanism of FIG. 6;

FIG. 9 is a perspective end view of a first drive assembly of the drivemechanism of FIG. 6 supported within a base member of the adapterassembly (shown in phantom);

FIG. 10 is an enlarged perspective end view of a proximal end of thefirst drive assembly shown in FIG. 9;

FIG. 11 is a perspective end view of a second drive assembly of thedrive mechanism of FIG. 6 supported within the base member of theadapter assembly (shown in phantom);

FIG. 12 is a perspective end view of the second drive assembly shown inFIG. 11;

FIG. 13 is another perspective end view of the second drive assemblyshown in FIG. 11;

FIG. 14 is a perspective end view of a third drive assembly of the drivemechanism of FIG. 6 supported within the base member of the adapterassembly (shown in phantom); and

FIG. 15 is a perspective end view of the third drive assembly shown inFIG. 14.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed adapter assembly for surgicaldevices and/or handle assemblies are described in detail with referenceto the drawings, in which like reference numerals designate identical orcorresponding elements in each of the several views. As used herein theterm “distal” refers to that portion of the adapter assembly or surgicaldevice, or component thereof, farther from the user, while the term“proximal” refers to that portion of the adapter assembly or surgicaldevice, or component thereof, closer to the user.

With reference to FIG. 1, an adapter assembly in accordance with anembodiment of the present disclosure, shown generally as adapterassembly 100, is configured for selective connection to a poweredhand-held electromechanical actuator shown, generally as handle assembly20. As illustrated in FIG. 1, the adapter assembly 100 is configured forselective connection with the handle assembly 20. A tool assembly or endeffector, e.g. tool assembly 30, which may, in exemplary embodiments,include a loading unit 40 and an anvil assembly 50, for applying acircular array of staples (not shown) to tissue (not shown) isconfigured for selective connection with the adapter assembly 100. Thehandle assembly 20, the adapter assembly 100, and the tool assembly 30form a surgical stapling device 10. Although shown and described for usewith a circular stapling loading unit, it is envisioned that the adapterassemblies of the present disclosure may be modified for use withstapling assembly having alternative configurations, and/or withnon-stapling end effectors.

For a detailed description of the structure and function of an exemplaryhandle assembly, please refer to commonly owned U.S. Pat. Appl. Publ.No. 2012/0253329 (“the '329 application”), the content of which isincorporated by reference herein in its entirety.

Referring initially to FIGS. 1-3, adapter assembly 100 includes aproximal portion 102 configured for operable connection to the handleassembly 20 (FIG. 1) and operable engagement by a user, and a distalportion 104 configured for operable connection to, and placement of, thetool assembly 30 (FIG. 1), including the loading unit 40 (FIG. 1) andthe anvil assembly 50 (FIG. 1). More particularly, the proximal portion102 of the adapter assembly 100 includes a base member 106, and a handlemember 108 rotatably secured to the base member 106. The distal portion104 includes a sleeve 109 fixedly secured to and extending from thehandle member 108. A central longitudinal axis “x” (FIG. 4) of theadapter assembly 100 is offset a distance “d” (FIG. 4) from a centrallongitudinal axis “y” (FIG. 4) of the handle assembly 20 (FIG. 1). Inone embodiment, the offset distance “d” is approximately 0.25 inches,while in another embodiment, the offset distance “d” is approximately0.075 inches.

The adapter assembly 100 includes a coupling assembly 110 disposedwithin the base member 106 of the adapter assembly 100 for operativelyconnecting the drive shafts (not shown) of the handle assembly 20 with adrive mechanism 118 of the adapter assembly 100. The coupling assembly110 includes first, second, and third connector sleeves 112, 114, 116rotatably supported within the base member 106 of the adapter assembly100. The first, second, and third connector sleeves 112, 114, 116 of thecoupling assembly 110 operably connect respective, first, second, andthird drive shafts (not shown) of the handle assembly 20 (FIG. 1) withrespective first, second, and third drive assemblies 120, 140, 160 ofthe drive mechanism 118 of the adapter assembly 100. For a more detaileddescription of an exemplary coupling assembly, please refer to commonlyowned U.S. Provisional Patent Application Ser. No. 62/066,518, filedOct. 21, 2014, the content of which are incorporated herein by referencein its entirety.

With reference now to FIGS. 9 and 10, the first drive assembly 120 ofthe drive mechanism 118 (FIG. 6) of the adapter assembly 100 includes afirst drive shaft 122 and a first distal drive shaft 124 rotatablysupported within the base member 106, and a first drive screw 126rotatably supported between a first housing plate 128 (FIG. 9; shown inphantom) and a thrust plate 130 (FIG. 9; shown in phantom). A proximalend of the first drive shaft 122 is operably connected to the firstconnector sleeve 112 of the coupling assembly 110. A distal end of thefirst drive shaft 122 includes a first drive gear 122 b integrallyformed therewith, or non-rotatably supported thereon. A proximal end ofthe first distal drive shaft 124 includes a second drive gear 124 aintegrally formed therewith, or non-rotatably supported thereon,operably connected with the first drive gear 122 b. A distal end of thefirst distal drive shaft 124 is operably connected to the first drivescrew 126. Although shown as separate components, it is envisioned thatthe first distal drive shaft 124 and the first drive screw 126 may bemonolithically formed. A proximal end of the first drive screw 126includes a gear flange 126 a integrally formed therewith, ornon-rotatably supported thereon. A distal end of the first drive screw126 includes a threaded portion 126 b.

The gear flange 126 a of the first drive screw 126 of the first driveassembly 120 is rotatably received between the first housing plate 128(FIG. 9; shown in phantom) and the thrust plate 130 (FIG. 9; shown inphantom). A first bearing assembly 134 (FIG. 5) facilitates rotation ofthe first drive screw 126 between the first housing plate 128 and thethrust plate 130. Although not shown, the thrust plate 130 engages thehandle member 108 of the adapter assembly 100 to distribute the loadfrom the first drive assembly 120 to the handle member 108. A centrallongitudinal axis of the first drive screw 126 extends along the centrallongitudinal axis “x” of the adapter assembly 100.

As shown in FIG. 4, a threaded proximal end 132 a of a trocar member 132of the first drive assembly 120 is operably received about the threadedportion 126 b of the first drive screw 126. Rotation of the first drivescrew 126 about the longitudinal axis “x” effects longitudinal movementof the trocar member 132. When the anvil assembly 50 (FIG. 1) is securedto a distal end 132 b of the trocar member 132, rotation of the firstdrive screw 126 in a first direction causes approximation of the anvilassembly 50 relative to the loading unit 40 (FIG. 1). Conversely,rotation of the first drive screw 126 in a second direction causes theanvil assembly 50 to move away from the loading unit 40. Alternatively,the first drive screw 126 operatively connects to a linearly orrotationally actuated assembly (not shown) of an end effector (notshown) for effecting performance of a first function, e.g., clampingtissue (not shown). In one embodiment, the thrust plate 130 may includea strain gauge for measuring the clamping forces during operation of thefirst drive assembly 120. By changing the size of the first and seconddrive gears 122 b, 124 a of the first drive assembly 120, the rate atwhich the drive screw 126 rotates relative to the input from the handleassembly 20 may be varied.

With reference now to FIGS. 11-13, the second drive assembly 140 of thedrive mechanism 118 (FIG. 6) of the adapter assembly 100 (FIG. 1)includes a second drive shaft 142 and a compound gear shaft 144rotatably supported within the base member 106, and a second drive screw146 rotatably supported between the gear flange 126 a of the first drivescrew 126 and a second housing plate 148. As will be described infurther detail below, when the second drive screw 146 of the seconddrive assembly 140 experiences a load in the proximal direction,engagement of the second drive screw 146 with the first drive screw 126of the first drive assembly 120 distributes the load from the seconddrive assembly 140 to the first drive assembly 120. This arrangementbalances the load experienced in the first drive assembly 120, i.e., inthe distal direction, with the load experienced in the second driveassembly 140, i.e., in the proximal direction, during operation of theadapter assembly 100.

A proximal end of the second drive shaft 142 of the second driveassembly 140 is operably connected to the second connector sleeve 114 ofthe coupling assembly 110. A distal end of the second drive shaft 142includes a first drive gear 142 b integrally formed therewith, ornon-rotatably supported thereon. A proximal end of the compound gearshaft 144 includes a second drive gear 144 a integrally formedtherewith, or non-rotatably supported thereon and a distal end of thecompound gear shaft 144 includes a third drive gear 144 b. The seconddrive gear 144 a is operably connected with the first drive gear 142 band the third drive gear is operably connected to the second drive screw146. As shown, the second drive gear 144 a includes a larger diameterthan the third drive gear 144 b. In this manner, the compound gear shaft146 operates to reduce the output speed and increase the output torquedelivered to the second drive screw 146 from the handle assembly 20. Inembodiments, the second compound gear shaft 146 replaces a planetarygear system (not shown), thereby saving space within the adapterassembly 100 and reducing the number of gears necessary for theoperation of the adapter assembly 100.

A proximal end of the second drive screw 146 includes a gear flange 146a integrally formed therewith, or non-rotatably supported thereon, inoperable engagement with the third drive gear 144 b of the compound gearshaft 144. A distal end of the second drive screw 146 includes athreaded portion 146 b. The second drive screw 146 of the second driveassembly 140 is received about the threaded portion 126 b of the firstdrive screw 126 of the first drive assembly 120 and accommodates receiptof the trocar member 132 of the first drive assembly 120 about thethreaded portion 126 a of the first drive screw 126.

The gear flange 146 a of the second drive screw 146 of the second driveassembly 140 is rotatably received between the gear flange 126 a of thefirst drive screw 126 and the second housing plate 148. A second bearingassembly 154 facilitates rotation of the second drive screw 146 betweenthe gear flange 126 a of the first drive screw 126 and the secondhousing plate 148. A central longitudinal axis of the second drive screw146 extends along the central longitudinal axis “x” (FIG. 4) of theadapter assembly 100.

The threaded portion 146 b of the second drive screw 146 operablyconnects to a linearly or rotationally actuated assembly (not shown) ofthe loading unit 40 (FIG. 1) of the tool assembly 30 (FIG. 1), or othersuitable end effector, for effecting performance of a second function,e.g., stapling tissue (not shown).

With reference now to FIGS. 15 and 16, the third drive assembly 160 ofthe drive mechanism 118 of the adapter assembly 100 includes a thirddrive shaft 162 and a compound gear shaft 164 rotatably supported withinthe base member 106, and a third drive screw 166 rotatably supportedbetween the gear flange 146 a of the second drive screw 146 and a thirdhousing plate 168. As will be described in further detail below, whenthe third drive screw 166 of the third drive assembly 160 experiences aload in the proximal direction, engagement of the third drive screw 166of the third drive assembly 160 with the second drive screw 146 of thesecond drive assembly 140, and engagement of the second drive screw 146of the second drive assembly 140 with the first drive screw 126 of thefirst drive assembly 120, distributes the loads from the second andthird drive assemblies 140, 160 to the first drive assembly 120. Thisarrangement balances the load experienced in the first drive assembly120, i.e., in the distal direction, with the loads experienced in thesecond and third drive assemblies 140, 160, i.e., in the proximaldirection, during operation of the adapter assembly 100.

A proximal end of the third drive shaft 162 of the third drive assembly160 operably engages the third connector sleeve 116 of the couplingassembly 110. A distal end of the third drive shaft 162 includes a firstdrive gear 162 b integrally formed therewith, or non-rotatably supportedthereon. A proximal end of the compound gear shaft 164 includes a seconddrive gear 164 a integrally formed therewith, or non-rotatably supportedthereon, and a distal end of the compound gear shaft 164 includes athird drive gear 164 b. The second drive gear 164 a is operablyconnected with the first drive gear 162 b and the third drive gear isoperably connected to the second drive screw 166. As shown, the seconddrive gear 164 a includes a larger diameter than the third drive gear164 b. In this manner, the compound gear shaft 164 operates to reducethe output speed and increase the output torque delivered to the thirddrive screw 166 from the handle assembly 20. In embodiments, the thirdcompound gear shaft 164 replaces a planetary gear system (not shown)used in previous embodiments, thereby saving space within the adapterassembly 100 and reducing the number of gears necessary for theoperation of the adapter assembly 100.

A proximal end of the third drive screw 166 includes a gear flange 166 aintegrally formed therewith, or non-rotatably supported thereon, inoperable engagement with the third drive gear 164 b of the compound gearshaft 164. A distal end of the third drive screw 166 includes a threadedportion 166 b. The third drive screw 166 of the third drive assembly 160is received about the second drive screw 146 of the second driveassembly 140 between the gear flange 146 a of the second drive screw 146and the threaded portion 146 b of the second drive screw 146.

The gear flange 166 a of the third drive screw 166 of the third driveassembly 160 is rotatably received between the gear flange 146 a of thesecond drive screw 146 of the second drive assembly 140 and the thirdhousing plate 168. A third bearing assembly 174 facilitates rotation ofthe third drive screw 166 of the third drive assembly 160 between thesecond flange 146 a of the second drive screw 146 of the second driveassembly 140 and the third housing plate 168. A central longitudinalaxis of the third drive screw 166 extends along the central longitudinalaxis “x” of the adapter assembly 100. Accordingly, each of the centrallongitudinal axes of the first, second, and third drive assemblies 120,140, 160 of the drive mechanism 118 extend along the centrallongitudinal axis “x” (FIG. 4) of the adapter assembly 100, i.e., thefirst second, and third drive screws 126, 146, 166 of the respectivefirst, second, and third drive assemblies 120, 140, 160 are coaxial. Inthis manner, an end effector attached to the distal portion 104 of theadapter assembly 100 may be rotated about the central longitudinal axis“x” to facilitate rotational positioning of the end effector.

The threaded portion 166 b of the third drive screw 166 of the thirddrive assembly 160 operably connects to a linearly or rotationallyactuated assembly (not shown) of the loading unit 40 (FIG. 1) of thetool assembly 30 (FIG. 1), or other suitable end effector, for effectingperformance of a third function, e.g., cutting tissue (not shown).

The operation of adapter assembly 100 will now be described withreference to the figures. The adapter assembly 100 is secured to thehandle assembly 20 (FIG. 1) and loading unit 40 of the tool assembly 30(FIG. 1) is secured to the adapter assembly 100 in a traditional manner.Subsequent to placement of the anvil assembly 50 (FIG. 1) of the toolassembly 30 (FIG. 1) through tissue to be stapled (not shown) and/or theplacement of the tissue to be stapled around the anvil assembly 50,e.g., with a purse-string suture, the anvil assembly 50 is secured tothe trocar member 132 of the adapter assembly 100.

The handle assembly 20 may then be actuated to cause individual orsimultaneous rotation of any of the first, second, and third driveshafts (not shown) of the handle assembly 20 to effect actuation of therespective first, second, and third drive assemblies 120, 140, 160 ofthe drive mechanism 118 of the adapter assembly 100.

Referring briefly to FIGS. 9 and 10, during actuation of the handleassembly 20 (FIG. 1) to actuate the first drive assembly 120, rotationof the first drive shaft (not shown) of the handle assembly 20 rotatesthe first connector sleeve 112, which rotates the first drive shaft 122,which rotates the first distal drive shaft 124 to cause rotation of thefirst drive screw 126. Rotation of the first drive screw 126 in thefirst direction causes longitudinal movement of the trocar member 132 inthe proximal direction, i.e., retraction, and rotation of the firstdrive screw 126 in the second direction causes longitudinal movement ofthe trocar member 132 in the distal direction, i.e., advancement.

As noted above, during actuation of the first drive assembly 120 of thedrive mechanism 118, the gear flange 126 a of the first drive screw 126engages the thrust plate 130. The configuration of the adapter assembly100 is such that the thrust plate 130 only experiences load duringactuation of the first drive assembly 120. In this manner, the adapterassembly 100 will have better resolution during operation than anadapter assembly (not shown) in which the thrust plate 130 experiencesadditional loads from the second and third drive assemblies 140, 160. Asnoted above, the thrust plate 130 may include a strain gauge formeasuring the clamping forces during operation of the first driveassembly 120.

Turning to FIGS. 11-13, during actuation of handle assembly 20 (FIG. 1)to actuate the second drive assembly 140, rotation of the second driveshaft (not shown) of handle assembly 20 rotates the second connectorsleeve 114, which rotates the second drive shaft 142, which rotates thecompound gear shaft 144 to cause rotation of the second drive screw 146.Rotation of the second drive screw 146 in the first direction causeslongitudinal movement of an attached first pusher member (not shown) ina distal direction, i.e., advancement, and rotation of the second drivescrew 146 in the second direction causes longitudinal movement of theattached pusher member (not shown) in a proximal direction, i.e.,retraction. As noted above, during actuation of the second driveassembly 140 of the drive mechanism 118, the gear flange 146 a of thesecond drive screw 146 engages the gear flange 126 a of the first drivescrew 126.

Turning to FIGS. 14 and 15, during actuation of handle assembly 20(FIG. 1) to actuate the third drive assembly 160, rotation of the thirddrive shaft (not shown) of handle assembly 20 rotates the thirdconnector sleeve 116, which rotates the third drive shaft 162, whichrotates the compound gear shaft 164 to cause rotation of the third drivescrew 166. Rotation of the third drive screw 166 in the first directioncauses longitudinal movement of an attached second pusher member (notshown) in a distal direction, i.e., advancement, and rotation of thethird drive screw 166 in the second direction causes longitudinalmovement of the attached pusher member (not shown) in a proximaldirection, i.e., retraction. As noted above, during actuation of thethird drive assembly 160 of the drive mechanism 118, the gear flange 166a of the third drive screw 166 engages the gear flange 146 a of thesecond drive screw 146 which engages the gear flange 126 a of the firstdrive screw 126.

The axial load path of the adapter assembly 100 extends through thefirst, second, and third drive screws 126, 146, 166 of the respectivefirst, second, and third drive assemblies 120, 140, 160. In this manner,the sleeve 109 of the adapter assembly does not experience loads fromthe second and third drive assemblies 140, 160. As noted above, thecommon central longitudinal axis of the first, second, and third driveassemblies 120, 140, 160 allows the sleeve 109 of the adapter assembly100 to be rotated along the longitudinal axis “x” of the adapterassembly 100.

Any of the components described herein may be fabricated from eithermetals, plastics, resins, composites or the like taking intoconsideration strength, durability, wearability, weight, resistance tocorrosion, ease of manufacturing, cost of manufacturing, and the like.

Persons skilled in the art will understand that the devices and methodsspecifically described herein and illustrated in the accompanyingdrawings are non-limiting exemplary embodiments. It is envisioned thatthe elements and features illustrated or described in connection withone exemplary embodiment may be combined with the elements and featuresof another without departing from the scope of the present disclosure.As well, one skilled in the art will appreciate further features andadvantages of the disclosure based on the above-described embodiments.Accordingly, the disclosure is not to be limited by what has beenparticularly shown and described, except as indicated by the appendedclaims.

What is claimed is:
 1. An adapter assembly for operably connecting anend effector to a handle assembly, the adapter assembly comprising: acoupling assembly; a first drive assembly extending from the couplingassembly and defining a first longitudinal axis, the first driveassembly including a first drive screw; a second drive assemblyextending from the coupling assembly and received about the first driveassembly, the second drive assembly defining a second longitudinal axisand including a second drive screw in engagement with the first drivescrew; and a third drive assembly extending from the coupling assemblyand received about the first and second drive assemblies, the thirddrive assembly defining a third longitudinal axis and including a thirddrive screw in engagement with the second drive screw.
 2. The adapterassembly of claim 1, wherein the coupling assembly includes first,second, and third connector sleeves.
 3. The adapter assembly of claim 2,wherein the first connector sleeve operably connects the first driveassembly to a first rotation transmitting member of a handle assembly,the second connector sleeve operably connects the second drive assemblyto a second rotation transmitting member of the handle assembly, and thethird connector sleeve operably connects the third drive assembly to athird rotation transmitting member of the handle assembly.
 4. Theadapter assembly of claim 1, wherein each of the first, second, andthird drive assemblies include a proximal drive shaft, a distal driveshaft, and a drive screw.
 5. The adapter assembly of claim 1, whereinthe first drive assembly includes a first drive screw having a threadedportion and a trocar member operably received about the threadedportion, rotation of the first drive screw causes longitudinal movementof the trocar member.
 6. The adapter assembly of claim 1, wherein thefirst, second, and third longitudinal axes are co-axial.
 7. The adapterassembly of claim 1, wherein the first drive assembly further includes athrust plate, the first drive screw engaging the thrust plate duringoperation of the first drive assembly.
 8. The adapter assembly of claim1, wherein the first, second, and third drive assemblies includerespective first, second, and third bearing assemblies for rotatablysupporting the respective first, second and third drive screws.
 9. Theadapter assembly of claim 1, further including a connection assemblyconfigured for operable connection to a handle assembly.
 10. The adapterassembly of claim 1, wherein each of the first, second, and third driveassemblies includes a housing plate for supporting the respective first,second, and third drive screws.
 11. The adapter assembly of claim 1,wherein the first, second, and third longitudinal axes are offset from alongitudinal axis of a handle assembly.
 12. The adapter assembly ofclaim 1, further including an outer sleeve, wherein each of the first,second, and third drive assemblies extends through the outer sleeve. 13.The adapter assembly of claim 12, wherein a distal end of the outersleeve is configured for operable connection to an end effector.